Participant Materials

The following materials provide information about RiverSpring FIDA Plan services. Feel free to contact us at 1-800-950-9000 if you have questions.

You can get this information for free in other languages. Call 1-800-950-9000 and TTY/TDD: 1-866-236-5800 during 8 a.m. – 8 p.m. Eastern time, 7 days a week. The call is free.

Usted puede obtener esta informacion en otros idiomas de forma gratuita. Llame al 1-800-950-9000 y TTY/TDD: 1-866-236-5800, 8 a.m. – 8 p.m. Hora del Este, los 7 días de la semana. La llamada es gratuita.

Ou ka jwenn enfòmasyon sa a gratis nan lòt lang. Rele nan 1-800-950-9000 ak nan TTY/TDD: 1-800-236-5800 ant 8:00 am ak 8:00 pm., Lè Zòn Lès, 7 jou pa semèn. Koutfil la gratis.

Vous pouvez obtenir ces informations gratuitement dans d’autres langues. Appelez le 1-800-950-9000 ou notre numéro TTY/TDD: 1-866-236-5800 – 7 jours sur 7 de 8 a.m. à 8 p.m. Heure de l’Est. L’appel est gratuit.

이정보는다른언어로도제공됩니다(무료). 주 7일 8:00 am – 8:00 pm 동부시간중 1-800-950-9000 나 TTY/TDD: 1-866-236-5800으로전화주십시오. 통화료는무료입니다.

您可免費取得以其他語言撰寫的資訊。請於週一至週日美國東部標準時間上午 8 時至下午 8時, 東部時間. 時致電: 1-800-950-9000,TTY/TDD 使用者: 1-866-236-5800。每週 7 天服務。此為免付費電話。

Данная информация доступна бесплатно на других языках. Звоните по номеру 1-800-950-9000 или 1-866-236-5800 (линия TTY/TDD) с 8:00 до 20:00 по восточному поясному времени 7 дней в неделю. Звонок бесплатный.

È possibile ricevere queste informazioni in altre lingue gratuitamente. Contatta il 1-800-950-9000 e TTY/TDD: 1-866-236-5800 dalle ore 8:00 alle ore 20:00 (ora standard orientale degli Stati Uniti), 7 giorni su 7. Il servizio è gratuito.

You can ask for these materials in other formats, such as Braille or large print. Call 1-800-950-9000, TTY/TDD: 1-866-236-5800, 8 a.m.-8 p.m. Eastern time, 7 days a week.

2018

Participant Handbook

English Spanish

Summary of Benefits

Provider and Pharmacy Directory

Dental Directory

Multi-Language Interpreter Services

Annual Notice of Change and Evidence of Coverage

Drug Formulary

English Spanish

2017

Participant Handbook (Evidence of Coverage)

English Chinese Haitian-Creole Italian Korean Russian Spanish

Summary of Benefits

English Chinese Haitian-Creole Italian Korean Russian Spanish

Provider and Pharmacy Directory

English Chinese Haitan-Creole Italian Korean Russian Spanish

List of Covered Drugs (Formulary)

English Chinese Haitian-Creole Italian Korean Russian Spanish

Multi-Language Interpreter Services

English

Appointment of Representative Form (CMS Form 1696)

English Spanish

Annual Notice of Change and Evidence of Coverage

English Chinese Haitian-Creole Italian Korean Russian Spanish

 

 

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This page was last updated on June 6,2018 09:30:00 EST